The Nurse Educators Perspectives of Clinical Teaching in the Skills Laboratory: A Malawian Experience

Purpose: Clinical skills laboratories continue to be an essential component of clinical teaching and learning in nurse education globally including the country of Malawi. As in many other developing countries, Malawi adopted the use of the skills laboratory through research findings and benchmarking from the well developed countries. The skills laboratory has been operational for more than ten years. However, it is not known how the clinical teaching and learning is taking place. In addition, much has been learned from developed countries but not much is known on how clinical teaching is progressing in many nursing institutions from the developing countries including Malawi. The aim of the study was to evaluate clinical teaching and learning of undergraduate nursing students in the skills laboratories from a developing world perspective. The purpose was to explore and determine nurse educators’ perspectives of clinical teaching and learning in college-based skills laboratories.

Methods: In 2013 six in-depth interviews from nurse educators and clinical supervisors were conducted at the two campuses of Kamuzu College of Nursing in Malawi. From these interviews the factors and issues that affect students’ clinical learning and use of the skills laboratory were extrapolated. Using a semi-structured interview guide, the participants were questioned on how teaching and learning is perceived, issues that affect clinical teaching and the areas that need modification for effective clinical teaching in the college-based skills laboratories. Data were organized and managed using the MAXQDA software version 11 and analysed thematically. 

Results: The findings show that demonstrations and return demonstrations are the practical necessities of clinical teaching that enrich clinical teaching experiences. The skills laboratory has better resources than the various practical sites and therefore it provides a better learning environment for undergraduate nursing students. Nurse educators perceive that it is stressful to conduct demonstrations and observe the return demonstrations due to the increased student numbers and limited resources available in the skills laboratory. There is also variation in the use of the skills laboratory by the junior and senior students. Junior students use the skills laboratory more than the senior because the senior students gain their experiences in the practical sites far from the college.  The need for nurse educators to work in shifts in the skills laboratory to create more opportunities for students to use the skills laboratory during their free time and when the lecturers are busy with other commitments, has been emphasised. Increasing the practice sessions, teaching resources and nurse educators is advocated to ensure effective clinical teaching. The findings also advocate the purchase of portable teaching resources for students who are allocated in various practical sites away from the college-based laboratories. Finally, a suggestion for a mentor-mentee program is made for graduates during the first two years of their working experience. However, in Malawi students are often alone in the work settings soon after graduation. It is possible that the staff shortage, due to nurse migration may preclude the development of this type of program.

Conclusion: These results suggest that strengthening the students clinical teaching in the skills laboratories is the most realistic strategy in developing countries